Healthcare Provider Details

I. General information

NPI: 1578245957
Provider Name (Legal Business Name): VICTORIA LITTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 MILES ST
DAMARISCOTTA ME
04543-4047
US

IV. Provider business mailing address

730 14TH ST SW STE 200
LOVELAND CO
80537-6349
US

V. Phone/Fax

Practice location:
  • Phone: 207-563-1234
  • Fax:
Mailing address:
  • Phone: 970-663-0815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019692
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: